Efficacy and safety of high-intensity focused ultrasound ablation for rectus abdominis endometriosis: a 7-year follow-up clinical study

The aim of this study was to evaluate the efficacy and safety of high-intensity focused ultrasound (HIFU) for the ablation of rectus abdominis endometriosis (RAE) as a noninvasive modality.All patients diagnosed with RAE who underwent HIFU ablation were followed up for 7 years. The following demographic characteristics of the patients were collected and analyzed: lesion location, size, and number; HIFU ablation; and recurrence.HIFU ablated 65 lesions in 56 patients with a median age of 36.5±9.19 years and a median lesion volume of 8.2 cm3. The main symptom was a palpable painful mass (n=61, 93.9%), which protruded from the skin surface in 6 cases (9.23%). Ultrasound was initially scanned in all patients (n=56, 100%), while 6% (n=3) required magnetic resonance imaging (MRI) to distinguish the features and range of the masses. Ablation was completed with a median sonication time of 393 s, a treatment time of 46 min, 150 W of power, and 63,525 J of total energy to treat lesions with a median volume of 5.03 cm3. There were no severe complications during the 84-month follow-up period, except for 2 patients who experiences hematuria. The pooled recurrence rate of RAE in this cohort was 1.8% (n=1).As HIFU is effective and safe and retains the integrity of the abdominal wall, it should be the preferred method for the treatment of RAE.